雌三醇联合康复训练对盆底功能障碍性疾病患者术后Ⅰ类、Ⅱ类肌纤维的影响  

Influence of Estriol Combined with Rehabilitation Training on Postoperative TypeⅠandⅡFibers of Patients with Pelvic Floor Functional Disorder

作　　者：刘从会 王孟君 王仲奇[1] 尹红[1] LIU Conghui;WANG Mengjun;WANG Zhongqi;YIN Hong(Department of Gynecology,Ankang Central Hospital,Ankang 725000,China)

机构地区：[1]安康市中心医院妇科,陕西安康725000

出　　处：《医学综述》2020年第19期3947-3952,共6页Medical Recapitulate

摘　　要：目的探讨雌三醇联合康复训练对盆底功能障碍性疾病(PFD)患者的临床疗效以及Ⅰ类、Ⅱ类肌纤维的影响及安全性。方法选择2016年3月至2018年2月安康市中心医院妇科收治的97例PFD患者为研究对象,按照治疗方法不同将患者分为对照组(康复训练,n=48)和研究组(康复训练联合应用雌三醇软膏,n=49)。比较两组患者治疗后的临床疗效,于产后6个月评估两组患者Ⅰ类、Ⅱ类肌纤维肌力分级和盆腔器官脱垂(POP)程度,同时分别于产后6周和产后6个月评估两组患者阴道动态压力、盆底静态张力、Ⅰ类和Ⅱ类肌纤维的肌电值及疲劳度,并分析两组患者治疗期间用药的安全性。结果研究组患者的临床总有效率高于对照组[91.84%(45/49)比77.08%(37/48)](P<0.05);研究组患者产后6个月Ⅰ类、Ⅱ类肌纤维肌力分级及POP程度分度均显著优于对照组(P<0.05)。产后6周和产后6个月阴道动态压力、盆底静态张力的主效应差异有统计学意义(P<0.05),两组间阴道动态压力、盆底静态张力的主效应差异有统计学意义(P<0.05),各指标时点间与组间存在交互作用(P<0.05),与对照组相比,研究组产后6个月阴道动态压力、盆底静态张力的提高幅度较大。产后6周和产后6个月Ⅰ类和Ⅱ类肌纤维的肌电值及疲劳度主效应差异有统计学意义(P<0.05),两组间Ⅰ类和Ⅱ类肌纤维的肌电值及疲劳度的主效应差异有统计学意义(P<0.05),各指标的时点间与组间存在交互作用(P<0.05),与产后6周相比,两组患者产后6个月Ⅰ类和Ⅱ类肌纤维的肌电值明显升高,而疲劳值均显著下降。结论雌三醇联合康复训练能够有效预防PFD的发生,同时改善POP程度和Ⅰ类、Ⅱ类肌纤维生理学指标。Objective To explore the clinical effect of estriol combined with rehabilitation training on patients with pelvic floor dysfunction(PFD),as well as the effect and safety on the typeⅠand typeⅡmuscle fibers.Methods A total of 97 cases of PFD patients admitted to the Department of Gynecology,Ankang Central Hospital from Mar.2016 to Feb.2018.According to different treatment methods,they were divided into a control group(rehabilitation training,n=48)and a study group(rehabilitation training combined with estriol ointment,n=49).The clinical efficacy of the two groups of patients after treatment was compared,the typeⅠand typeⅡmuscle fiber strength classification and the degree of pelvic organ prolapse(POP)in the two groups at 6 months postpartum were assessed,and the vaginal dynamic pressure,pelvic floor static tension,myoelectric value and fatigue of typeⅠand typeⅡmuscle fibers at 6 weeks and 6 months postpartum were assessed,and the safety of medication during treatment were analyzed.Results The total clinical effective rate of the study group was higher than that of the control group[91.84%(45/49)vs 77.08%(37/48)](P<0.05);the typeⅠand typeⅡmuscle fiber muscle strengthclassification and POP degree of the study group were significantly better than those of the control group(P<0.05).The main effects of vaginal dynamic pressure and pelvic floor static tension at 6 weeks and 6 months postpartum were statistically significant(P<0.05),and the main effects of vaginal dynamic pressure and pelvic floor static tension between the two groups were statistically significant(P<0.05),there was an interaction in each index between time points and groups(P<0.05).Compared with the control group,the dynamic pressure of vagina and the static tension of pelvic floor in the study group increased greatly at 6 months postpartum.There was a statistically significant difference in the main effect of the EMG value and fatigue degree of typeⅠand typeⅡmuscle fibers between 6 weeks postpartum and 6 months postpartum(P<0.05),abd

关 键 词：盆底功能障碍性疾病 雌三醇 康复训练 肌纤维 安全性 

分 类 号：R711.5[医药卫生—妇产科学]